Challenges Associated With The Phone Call – HIV Treatment Retention Technique Among Adolescent Patients In The Kumasi Metropolis, Ghana

Introduction: One of the goals of UNAIDS’ 90-90-90 is ensuring that 90 percent of people on antiretroviral (ARV) treatment are virally suppressed. Viral suppression is possible through the long-term, correct usage of ARVs, and can be achieved through mechanisms in the health system to promote compliance among these patients. A phone call is one of the HIV care retention techniques being used by healthcare professionals working in ART clinics to trace loss to follow-up. This technique may be associated with challenges that hinder the retention of adolescents in medical care. The aim of this study was to explore challenges associated with the phone call HIV treatment retention technique that adolescent HIV patients and ART healthcare providers face in the Kumasi Metropolis in the Ashanti Region, Ghana. 

Method: A qualitative study was conducted at four (4) selected ART clinics, from September 2017 to February 2018. In-depth individual interviews were conducted with thirty (30) consented patients (aged 14-19 years) on ARV for a minimum period of one year and16 healthcare professionals working in the ART clinics, purposively sampled. The thematic approach was used to analyse the data.

Results and Discussion: The challenges associated with the phone call technique include patient/carrier not having personal phones (not feeling comfortable enough with using other people’s phones out of fear of raising suspicion and evoking questions that might lead to the disclosure of their HIV status, fear of stigmatisation by community members, fear of confidentiality breach by the healthcare provider); difficult to reach lost to follow up (wrong telephone numbers, wrong house address, client/carrier travel without appropriate arrangement and loss of the primary phone owner); logistical problems; and contract adherence monitors.

Conclusion: Phone calls can help to identify and trace adolescent HIV patients (lost to follow-up) but several challenges and issues need to be addressed when employing the phone call HIV treatment retention technique.